ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

 Click here to read this article as a CME activity

Ann Thorac Surg 2008;86:927-932. doi:10.1016/j.athoracsur.2008.04.021
© 2008 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stephen D. Cassivi
Mark S. Allen
Dennis A. Wigle
Francis C. Nichols
Peter C. Pairolero
Claude Deschamps
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Cassivi, S. D.
Right arrow Articles by Deschamps, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cassivi, S. D.
Right arrow Articles by Deschamps, C.
Related Collections
Right arrow Professional affairs
Right arrowRelated Article

Original Articles: General Thoracic

Patient-Centered Quality Indicators for Pulmonary Resection

Stephen D. Cassivi, MD, MS*, Mark S. Allen, MD, Gregg D. Vanderwaerdt, MPA, Lori L. Ewoldt, RN, Mary E. Cordes, RN, Dennis A. Wigle, MD, PhD, Francis C. Nichols, MD, Peter C. Pairolero, MD, Claude Deschamps, MD

Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota

Accepted for publication April 9, 2008.

* Address correspondence to Dr Cassivi, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Email: cassivi.stephen{at}mayo.edu).

Presented at the Poster Session of the Forty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 29–31, 2007.

Background: Quality of care is increasingly scrutinized. However, no standard quality measures exist for surgical care of patients undergoing pulmonary resection.

Methods: Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed.

Results: In all, 606 patients (men:women = 330:276) underwent 628 pulmonary resections. Median age was 65.8 years (range, 2 to 93). Operative mortality was 2.1%. Pulmonary function testing within 1 year before surgery was documented in 74.2%. Electrocardiogram within 90 days before surgery was documented in 81.6% of patients 50 years and older. Smoking history was documented in all patients, and smoking cessation consultation was offered to 85.7% of current smokers. Deep venous thrombosis prophylaxis was implemented in 99.7%. Mediastinal staging was documented in 94.0% of patients undergoing lung cancer resection (n = 333). Postoperatively, 92.4% of patients used incentive spirometry. Atrial fibrillation treatment occurred within 45 minutes of onset in 70.5%. Postoperative analog pain scores were above 6 in only 7.4% of assessments; treatment and reassessment occurred within 2 hours in 81.0%. Follow-up planning was documented at hospital discharge in 100%. No National Quality Forum "never events" occurred.

Conclusions: Patient-centered and clinically relevant quality measures can be developed and evaluated in general thoracic surgery. This panel of quality indicators highlights and guide areas for potential improvement in the care of patients undergoing pulmonary resection.


Related Article

Invited Commentary
Alex G. Little
Ann. Thorac. Surg. 2008 86: 933. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
M. S. Allen, L. Halgren, F. C. Nichols III, S. D. Cassivi, W. S. Harmsen, D. A. Wigle, K. R. Shen, and C. Deschamps
A randomized controlled trial of bupivacaine through intracostal catheters for pain management after thoracotomy.
Ann. Thorac. Surg., September 1, 2009; 88(3): 903 - 910.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. A. Defranchi, S. D. Cassivi, F. C. Nichols, M. S. Allen, K. R. Shen, C. Deschamps, and D. A. Wigle
N2 disease in T1 non-small cell lung cancer.
Ann. Thorac. Surg., September 1, 2009; 88(3): 924 - 928.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
S. C. Tomaszek, S. D. Cassivi, K. R. Shen, M. S. Allen, F. C. Nichols III, C. Deschamps, and D. A. Wigle
Clinical Outcomes of Video-Assisted Thoracoscopic Lobectomy
Mayo Clin. Proc., June 1, 2009; 84(6): 509 - 513.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
A. Kozian, T. Schilling, H. Schutze, F. Heres, T. Hachenberg, and G. Hedenstierna
Lung computed tomography density distribution in a porcine model of one-lung ventilation
Br. J. Anaesth., April 1, 2009; 102(4): 551 - 560.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. G. Little
Invited Commentary
Ann. Thorac. Surg., September 1, 2008; 86(3): 933 - 933.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The Society of Thoracic Surgeons.